title: Cardiovascular screening in rheumatoid arthritis: a cross-sectional primary care database study.
abstract: BACKGROUND
  Patients with rheumatoid arthritis (RA) are known to be at increased risk of vascular disease. It is not known whether screening for vascular risk factors occurs in primary care. The aim of this study was to determine whether guidance advocating cardiovascular screening in RA patients is being implemented in primary care.
  
  
  METHODS
  This study was undertaken in a UK primary care consultation database. All patients with a diagnosis of RA between 2000 and 2008, and still registered with the GP practice in 2009 were matched by age, gender and GP practice to three non-RA patients. Evidence of screening for five traditional vascular risk factors (blood pressure, lipids, glucose, weight, smoking) was compared in those with and without RA using logistic regression models. A comparison was also made with diabetes.
  
  
  RESULTS
  401 RA patients were identified and matched to 1198 non-RA patients. No differences in the overall rates of screening were found (all five risk factors: RA 24.9% vs no RA 25.6%), but RA patients were more likely to have a smoking status recorded (67% versus 62%). In contrast, those with diabetes were up to 12 times as likely to receive vascular screening.
  
  
  CONCLUSIONS
  Despite the excess risk of vascular disease in patients with RA being of a similar magnitude to that seen in diabetes, patients with RA did not receive additional CVD screening in primary care, although this was achieved in patients with diabetes. More emphasis needs to be placed on ensuring those with RA are actively screened for cardiovascular disease in primary care.
authors.affiliation: Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, UK. s.muller@keele.ac.uk.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Monk
authors.forename: Sara
authors.initials: S
authors.lastname: Muller
authors.forename: Christian D
authors.initials: CD
authors.lastname: Mallen
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Hider
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000453:epidemiology; D001786:Blood Glucose; D001795:Blood Pressure Determination / Q000706:statistics & numerical data; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000175:diagnosis* / Q000453:epidemiology; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D050177:Overweight / Q000175:diagnosis* / Q000453:epidemiology; D011320:Primary Health Care / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000706:statistics & numerical data*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
chemical_list: D001786:Blood Glucose